CAPILLARY FRAGILITY IN THE SKIN OF THE ALBINO RAT AND ITS RELATION TO THE HAIR CYCLE

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T H IS D IS S E R TA TIO N HAS BEEN M IC R O F IL M E D E X A C T L Y AS R E C E IV E D .

UBRARI Of war TORI WIV1R8TTT 0IT71RSITT HEIGHT?

CAPILLARY FRAGILITY I N THE SKIN OF THE ALBINO RAT AND I T S RELATION TO THE HAIR CYCLE

A d i s s e r t a t i o n i n t h e D e p a r t m e n t o f Anatomy su b m itte d t o th e f a c u lty o f the G r a d u a t e S c h o o l o f A r t s and S c i e n c e i n p a r t i a l f u l f i l l m e n t o f the re q u ir e m e n ts f o r the d e g r e e o f D octor of P h ilo so p h y

George Kozam June 1950

CAPILLARY FRAGILITY IN THE SKIN OF THE ALBINO RAT AND I T S RELATION TO TH1\ HAIR CYCLE In tro d u ctio n Page T ests fo r

th e

s t u d y o f C a p i l l a r y F r a g i l i t y ................................. 1

T h e N e g a t i v e P r e s s u r e P r i n c i p l e ....................................1 T h e P o s i t i v e P r e s s u r e P r i n c i p l e ................................

2

C h e m i c a l M e t h o d s ........................................................................ 4 T h e E c c h y m o s i s T e s t . . . ........................................................

7

M e c h a n i s m s o f C a p i l l a r y H e m o r r h a g e ................................................... 8 F a c to rs R e g u la tin g

C a p i l l a r y H e m o r r h - g e ...................................... 9

H e m o s t a t i c F a c t o r s ...................................................................... 1 1 S t r e n g t h o f C a p i l l a r y V a i l ................................................. 11 I n t r a v a s c u l a r P r e s s u r e ............................................................12 T o n u s .........................................................................................................1 3 H a i r C y c l e s o f t h e A l b i n o R a t ................................................................. 1 5 M ethods The A p p lic a tio n and S ta n d a r d iz a tio n P ressure

P rin cip le

of th e N egative

t o t h e A l b i n o R a t .............................................. 17 O b serv atio n s

T h e N o r m a l A n i m a l .................................................................................................2 1 T h y r o x i n A d m i n i s t r a t i o n .................................................................................2 5 The A d m i n ls tr a r io n

o f S e x H o r m o n e s ....................................................2 6

E s t r o g e n ..................................................................................

26

P r o g e s t e r o n e ...................................................................................... 2 8 E s t r o g e n a n d P r o g e s t e r o n e C o m b i n a t i o n .................... 2 8 T e s t o s t e r o n e ......................................................................................2 9 2 0

a

5 ^ 0

Page The E f f e c t o f O r c h id e c to m y , O v a rie c to m y , A d r e n a l e c t o m y ..................................................................................................... 2 9 I n a n i t i o n ...............................................................................................................

30

I r r a d i a t i o n ..........................................................................................................

32

P h y s ic a l A gents:

H eat,

C old,

and H igh B a ro m e tric

P r e s s u r e ..................................................................................................................

34

C h e m i c a l A g e n t s . . ..........................................................................................

J6

L o cal:

H istam in e, N ic o tin e ,

G en eral:

H ep arin ,

A d ren alin e

36

D i c o u m a r o l ...................................... 3 7

D iscu ssio n T i s s u e T u r g o r a n d t h e D a m p i n g E f f e c t ........................................ C a p illary F ra g ility

38

a n d H a i r E r u p t i o n ......................................... 4 5 Sum m ary G raphs and P h o to g ra p h s L itera tu re

C ited

INTRODUCTION T ests

fo r C a p illary F ra g ility The c u t a n e o u s m a n i f e s t a t i o n s

of c ap illa ry

and h em o rrh ag ic d i a t h e s i s have been observed s in c e tim e s.

D uring th e

p u rp u ric

last

occur in

th e

years,

u n d ersto o d .

co n ju n ctio n w ith

m easles,

cap illa ry

d ire c tly

e .g .,

a d i s t u r b e d vasom otor a c t i o n .

by t o x i n s ,

seen in

endocrine d y s­

sp le e n and th e r e tic u lo - e n d o fra g ility

has a ls o been

p e r m e a b i l i t y w here t h e r e A sta te

of cap illa ry

te le a n g ie c ta sia ,

Sham berg’ s d i s e a s e ,

is

fra g ility ,

n o t uncomm only f o u n d i n t h e m ore l o c a l i z e d ,

c o n d itio n s such a s M ajo cch i* s d i s e a s e ,

pigenosum ,

and

e n d o th eliu m i s i n ­

m en stru al d is o r d e rs ,

c ap illa ry

in w hich

O thers a re

c ap illa ry

A ty p e o f c a p illa r y

a scrib e d to in creased

is

and urem ia,

such a s scu rv y .

and d i s e a s e s o f th e

sy stem .

m oreover,

such as s c a r l e t

e n d o th e liu m i s damaged d i r e c t l y

affected ,

fu n ctio n s,

and a few o f t h e i r 1 Some a r e c o n s i d e r e d to

sm allp o x ,

s y s te m ic d i s e a s e s i n w hich th e

a to lo g ic

h o w e v e r , man y o f t h e s e

sy stem ic d is e a s e s ,

d ip h th e ria ,

in v itam in d e f ic ie n c ie s

th elial

an cien t

c o n d itio n s have been c l a s s i f i e d

u n d erly in g p rin c ip le s

fever,

fifty

fra g ility

derm -

angiom a s e r o rth o static

2 purpura,

and d e r m a t i t i s h e m o s t a t i c a



V a rio u s t e s t s have been d e v is e d , s in c e th e p io n e e r 3 w ork o f H ech t i n 1907, t o e s t im a t e c a p i l l a r y s t r e n g t h and t o u n d e rs ta n d t h e d i s t u r b e d p h y s io lo g y w hich b r in g s a b o u t th ese m a n ife sta tio n s. or n eg ativ e p re ssu re

T his i n v e s t i g a t o r p rin cip le -1

em ployed t h e

su c tio n

t o d e te r m i n e t h e amount o f

p a r t i a l vacuum n e c e s s a r y

fo r th e p ro d u ctio n of c a p illa r y

p e t e c h i a l hem orrhage i n t h e

s k in o f hum ans.

He t e s t e d

or

d if­

f e r e n t age groups and v a r io u s r e g io n s o f graded

su c tio n p re s s u re s .

w hich c o r r o b o r a te d m o d ifica tio n

t h i s w ork.

o f t h e b ody by t h e u s e 4 F ro n ta li perform ed e x p e rim e n ts 5 Da S i l v a - M e l l o co n stru cted a

o f H e c h t Ts a p p a r a t u s w h i c h h e c a l l e d

"ca p illa ry

6 resisto m e te r".

A sim ilar

d e v i c e w a s d e v e l o p e d b y Von B o r b e l y . 7 a n d e m p l o y e d by A r m e n t a n o a n d S z e n t - G y o r g y i n s t u d i e s on 8 ,9 V item in P . C u t t e r , M a r q u a r d t, and J o h n s o n in tro d u ced th e f i r s t m ethod f o r t h e m ic r o s c o p ic o b s e r v a t i o n teste d

by n e g a t i v e p r e s s u r e .

The end o f t h e n a i l

se rv e d u n der the m icroscope a f t e r su c tio n

by means o f a g l a s s

of c a p illa rie s

fin g er

it

bed w as o b ­

had been s u b je c te d

to

a p p l i a n c e a n d pump a p p a r a ­

tu s .

g ility ,

The s e c o n d a p p r o a c h t o t h e s t u d y o f c a p i l l a r y f r a 10,11 t h e R um pel-L eede t e s t , w a s b a s e d on t h e p o s i t i v e

pressure lary

p rin cip le .

pressure

In flated low t h e

It

em ployed t h e

in crease

of i n t r a c a p i l ­

by m e a n s o f a c u f f p l a c e d o n t h e u p p e r a r m a n d

u n t i l p e t e c h i a l hem orrhages app eared in th e c o n stric te d

area.

T h i s m e th o d was i n t r o d u c e d

sk in

be­

in to

th is

c o u n t r y a s t h e " c a p i l l a r y r e s i s t a n c e t e s t " by H e s s a n d 12 1 F ish . o tephan u s e d t h e t e r m " e n d o t h e l i a l symptom" t o

d escrib e test

fin d in g re s u ltin g

from t h e

use o f t h i s

and w hich he c o n s id e r e d a s i n d i c a t i n g a p a t h o l o g i c c o n ­

d itio n tern.

a p o sitiv e

of the e n d o th e lia l c e lls of th e e n tir e c a p illa r y sy s 13 G o eth lin fu rth e r stan d ard ized th is p o sitiv e p ressu re

p rin cip le produced

fo r ro u tin e c lin ic a l usage. in

a 1 sq.

cm. a r e a ,

T he n u m b e r o f p e t e c h i a e

dem arcated in th e a n t e c u b i t a l

fossa,

by a c u f f p r e s s u r e

m u ltip lied

o f 5 0 mm Hg i n

by a f a c t o r o f tw o .

to th e p e te c h ia l count o b tain ed ing th e

cuff pressure

T his h a s atio n s

to

T his p r o d u c t i s in th e

sam e a r e a by i n c r e a s ­

7 0 mm Hg f o r a n o t h e r

o f t h i s m ethod h a v e b e e n em ployed, o th ers u sin g a su p ra d ia sto lic Thus,

itiv e ,

are

in

th e

used f o r

th e end p o in t orrhage

then added

15 m i n u t e s .

come t o b e k n o w n a s t h e G r o e t h l i n I n d e x .

d ia sto lic ,

te stin g

sk in .

p lo y in g n e g ativ e m ore a d a p t a b l e

and pos­

o f p e t e c h i a l hem­

A ll o th er pressure t e s t s o f th e s e m ethods.

have been

t h e o n e em2 6 ,1 4 or s u c t i o n p r e s s u r e has b e e n found t o be

and s u i t e d

to th e te s tin g

th e c o n d itio n s

Of th e s e ,

o f a g r e a t e r number

The p o s i t i v e

n iq u e s , how ever, th o u g h l im i te d

fra g ility

n e g ativ e

th e s tr e n g th o f blood v e s s e l s w ith

o f r e g i o n s on t h e human b o d y .

p ro x im ate

v a lu e .

of each b ein g th e p ro d u c tio n

the

Many v a r i ­

some u s i n g a n i n f r a -

two p r e s s u r e p r i n c i p l e s ,

fu rth e r m o d ificatio n s

lary

15 m in u te s i s

in t h e i r

pressure

use,

tech ­

m ost n e a r l y

o f spontaneous hem orrhage in

ap­

cap il­

sta te s.

T h e r e h a s b e e n m u ch v a r i e t y cup and th e l e n g t h o f t h e

in th e

size

of th e

test

p eriod used i n th e p ro d u c tio n 3 15 of c u tan eo u s p e te c h i a l hem orrhages. H echt , M engler ,

5 Da S i l v a - M e l l o (3 t o

test

16 , and Tey

5 cm .) f o r a p e r i o d

used cups o f v e ry la r g e d ia m e te rs o f one m in u te .

The o n e - m in u te

test

p e r i o d w i t h 2 cm. c u p s w a s b e l i e v e d t o be m o r e s u i t a b l e b y , 6 17 18 14 von B o rb e ly , J e r s i l d a n d Elm by , and F ra n k e • C opley found,

by v a r y i n g t h e

th a t th e

t e s t p e r i o d f r o m 15 s e c o n d s t o 4 m i n u t e s ,

lo n g er te s ti n g

tim e

a p p e a r e d t o p r o d u c e more p e t e c h i a l

-3

hem orrhages.

A tw o-m inute s u c t i o n

tim e , w i t h a 4*5 cup,

h o w e v e r, g a v e th e m ost c o n s i s t e n t r e s u l t s . 19 H ess d e v e l o p e d t h e f i r s t c h e m i c a l t e s t by a p p l y i n g 20 t h e p u n c t u r e te c h n iq u e o f Koch i n w hich th e s k in i s l i g h t l y p ric k e d w ith a f in e need le and observed th e f o r th e p resen ce o f b leed in g

p o in ts.

in d ic a te a b leed in g tendency. hem orrhages r e s u lte d th eria

fo llo w in g day

T hese w ere c o n s id e r e d t o

Hess o b se rv e d w h e th e r c a p i l l a r y

from s u b c u ta n e o u s i n j e c t i o n s

o f d ip h ­

a n tito x in .

jec tio n .

He f o u n d n o p e t e c h i a e a t t h e s i t e o f i n 21 L eschke and Y /ittkow er found t h a t s o lu tio n s of

0.25/& s o d i u m c h l o r i d e i n j e c t e d irrita tio n

R o sen th al,

produced an

le a d in g to th e d ev elo p m en t o f su b c u ta n e o u s h em ato-

m ata i n p a t i e n t s h a v in g and b e t t e r

su b cu tan eo u sly

b leed in g te n d e n c ie s .

A m ore r e c e n t

c o n t r o l l e d c h e m i c a l m e t h o d w a s i n t r o d u c e d by P e c k , 22 23 and E r f who i n j e c t e d i n t r a d e r m a l l y a s t a n d a r d i z e d

c o n c e n t r a t i o n o f m o c a s s i n s n a k e v e n o m o f know n h e m o r r h a g i n co n ten t.

R e a d i n g s w e r e m ade a t

r e a c t i o n was c o n sid e re d

to

30 a n d 60 m i n u t e s a n d a p o s i t i v e

be th e a p p e a ra n c e ,

hour,

of p e t e c h i a l hem orrhages or ecch ym o sis a t

site.

T h i s venom t e s t

fra g ility te sts,

in

can be

a lo calized

such as th e

area

the

in je ctio n

used t o d e te rm in e

cap illa ry

not a cc essib le

to u rn iq u et

cheek, gum s, p e r i a n a l ,

O ther te c h n iq u e s

w i t h i n one

and p e r i n e a l r e g i o n s .

ch em ical p r i n c i p l e 24 h a v e b e e n d e s i g n e d by C h a m b e rs an d C o p l e y fo r th e study o f cap illa ry

stre n g th in

u tiliz in g

to

th e

th e m ucous m em branes o f a n im a l s .

V a r io u s h em orrhagim s w ere i n j e c t e d

-

4-

in trad erm ally

in to the

n i c t i t a t i n g m em brane

of th e

r a b b i t ’ s eye and th e

flow o f

b lo o d and r u p t u r e

o f v e s s e l s w ere o b s e r v e d by m ean s o f a 25 b in o c u la r d i s s e c ti n g m icro sco p e. C opley has a lso ap p lied th is

tech n iq u e to

in d iv id u a l te ste d tio n

th e o r a l pouch o f th e

blood v e s s e l s

by s u c t i o n

o f drugs to

o f the tr a n s - illu m in a te d

procedure a f t e r the

gold en h a m ste r.

test

The

pouch w ere

th e in tra d erm al a d m in istra ­

area.

26 As p o i n t e d

o u t by F r i s c h k n e c h t

, and Peck and

31 C opley cip les

, how ever, are

both p o s i t i v e

o b jec tio n a b le

n o n -p h y sio lo g ic

and n e g a tiv e p re s s u re

because th ey in d u ce a c o m p le te ly

stim u lu s to

a c t on t h e

c ap illa ry

bed.

f o r m e r p r o d u c e s p e t e c h i a l h e m o r r h a g e by a n i n c r e a s e d v a s c u la r p re s s u re w hile th e p ressu re w ith p assiv e

la tte r

d ila ta tio n

i c a l m ethods, m oreover,

in tro d u ce

how ever,

in d ic ate

of se n sitiv ity

in

th at

o f the

the

c ap illa ry

in tra -

bed.

Chem­

a f o r e i g n m edium i n t o

the

n o t e x a c t l y known.

accepted r e s u l t s th ere

T he

low ers th e p e r iv a s c u la r

t e s t a r e a w hose m ethod o f a c t i o n i s The g e n e r a l l y

p rin ­

of a ll

th ese

te sts,

are g re a t re g io n a l v a r ia tio n s

sa m e h u m a n s u b j e c t .

T h is h as been con6 Von B o r b e l y ,

,

f i r m e d r e p e a t e d l y by m any i n v e s t i g a t o r s . 15 27 18 M engler , W iemer , and F ra n k e found th e u p p e r r e g i o n s 14 o f t h e body more s e n s i t i v e t h a n t h e l o w e r o n e s . C opley h a s n o t been a b le areas in th e illa ry

to v e rify

sa m e i n d i v i d u a l

resistan ce.

sym m etric s k in

alw ays m a i n t a i n e d

T h is a u th o r ,

th e view t h a t c a p i l l a r y u re d on th e

statem en ts th a t

a lso ,

t h e sam e c a p ­

could n o t co n cu r i n

r e s i s t a n c e rem ain ed

c o n s ta n t as m eas­

sa m e r e g i o n o f t h e b o d y o n d i f f e r e n t d a y s .

-5-

26 F risch k n ech t

b eliev ed

u n su itab le fo r

su ctio n te s tin g

to d istu rb in g

t h a t t h e a n t e c u b i t a l f o s s a e w ere

f a c to r s such as

because o f t h e i r exposure arm m o v e m e n t s , b l o o d p r e s s u r e

d eterm in atio n s,

and venous p u n c tu r e s , r o u t i n e l y p erfo rm ed 17 18 in m ed ical ex am in a tio n s. J e r s i l d a n d Elm by , Franke ,

26 and F risc h k n e c h t

b eliev ed t h a t th e

su p ra cla v ic u la r

r e g i o n was b e s t f o r th e t e s t i n g o f c a p i l l a r y r e s i s t a n c e . 14 C opley found t h a t t h e i n t e r n a l b r a c h i a l r e g i o n o f f e r e d th e m ost f a v o r a b le stre n g th th is

and c a p i l l a r y

a re a to

lea st

co n d itio n s

exposed

for th e te s tin g

of c a p illa ry

h em o rrh ag ic d i a t h e s i s .

He b e l i e v e d

be m o st s u s c e p t i b l e to s tim u li,

to p u rp u ric

re la tiv e ly

free

p ro d u ctio n ,

from h a i r ,

lack in g

i n pigm ent,

and e a s ily a c c e s s ib le . 14 ,2 8 R e c e n t w ork h a s shown t h a t t h e p e t e c h i a l

co u n t,

a s p e r f o r m e d by some p r e v i o u s a u t h o r s ,

stan t as

fo rm erly b e lie v e d .

n e c e ssity of d u p lic ate

i s not as con­

Many a u t h o r s h a d i g n o r e d t h e

or t r ip lic a te

re su lts

as confirm atory

m easures.

O thers had n o t a p p re c ia te d th e p o s s i b i l i t y

a lte ra tio n

of

area.

t h e r e s p o n s e by r e p e a t e d t e s t i n g i n a r e s t r i c t e d 14 27 C opley , a n d W iemer have n o ted t h a t th e resp o n se

to n eg ativ e p ressu re

t e s t s was

o ften a lte re d

s e r i o u s l y i m p a i r e d by m u c h r e p e a t e d area.

o f an

te stin g

and som etim es

in a lim ite d

I t w as s u g g e s t e d by C o p le y t h a t t h e c a p i l l a r y

c i r c u l a t i o n m ay be a l t e r e d b y w o u n d t h r o m b i o r c h a n g e s i n th e

lo c a l nervous c o n tr o l

o f th e

c a p illa ry

bed.

A m u lti­

a p e r t u r e l u c i t e c u p was d e v i s e d , t h e r e f o r e , b y C o p l e y a n d 29 B lak ely , h av in g 3 to 7 a p e r tu r e s in n e a r p ro x im ity , each

-6-

w i t h a d i a m e t e r o f 4* 5 aim.

T h is cup p e rfo rm e d

several te s ts

sim u ltan eo u sly .

When c o m p a r e d w i t h t h e

ual te s ts

same a r e a i t w a s f o u n d t h a t d e t e r m i n a t i o n s

in th e

w ith th ese iae

c u p s w e re m ore c o n s t a n t i n

produced in each a p e r tu r e ,

in th e

re su lts

of in d iv id ­

t h e number of p e t e c h -

though c o n s id e r a b le

v a ria tio n

c o u n t s was s t i l l

en co u n tered . 30 In v estig a to rs h a v e n o t e d i n so m e c a s e s t h a t r . a n y

hem orrhages a p p ea re d a f t e r m ild s u c t io n p ro c e d u re y e t m ained d i s c r e e t l y was f o u n d t h a t

v isib le .

In

o th er s u b je c ts ,

rig o ro u s su c tio n

ru p tu red v e s s e ls ,

obscure th e

how ever,

was o f s u c h q u a n t i t y

g iv in g a t th e t e s t

area

th e n e g a tiv e

cases.

number o f p e t e c h i a l h em o rrh a g es fuse.

The i n t e n s i t y

in th re e

red

p lacq u es,

and s t a n d a r d i z e d degree

The e c c h y m o s is t e s t ,

pressure p rin c ip le ,

but a lso

of th e p u rp u ric

cup

( 4 . 5 mm i n d i a m e t e r ) .

a p u rp u ric m a n ife sta tio n th e

last

in d ic ate s

th e p resen ce

u tilizin g

th eii

t e n d e n c y to

e r u p tio n was th en

i n c r e m e n t s : 1 + , 2 i , a n d 3+»

by t h e

of ecchym otic

e s tim a te d n o t only t h e

The f i r s t

d e n o t e s e c c h y m o s i s w h i c h c o v e r s a b o u t 33% o f t h e teste d

as to

They c o a l e s c e d

larg e

icnown a s e c c h y m o . i s . A m ethod was d e v i s e d 3 0,14 by C o p l e y , t h e r e f o r e , to m easure th e in v o lv em en t in th e s e

it

The b l e e d i n g f r o m

o r i g i n a l p o in ts of hem orrhage.

i n m an y c a s e s

how ever,

t r e a t m e n t was n e c e s s a r y to

p ro d u ce c o m p a r a tiv e ly few p e t e c h i a e . th ese

re­

g rad atio n surface area

The s e c o n d r e f e r s

c o v e r i n g 66% o f t h e

com plete c o v e ra g e .

graded

to

t e s t a re a , w h ile

A fter sta n d a rd iz a tio n ,

o f e c c h y m o t i c i n v o l v e m e n t o f - 3 0 0 mm Hg o r l e s s

(f o r 2 m in utes)

was c o n s i d e r e d

to

hem o rrh ag ic d i a t h e s i s .

-

7-

be p a t h o g n o m o n i c f o r

c ap illa ry

Mechanisms of Capillary Hemorrhage A study in th is

of th e

lite ra tu re

in d icates

th at

w orkers

field

r e c o g n i z e t h r e e m e c h a n i s m s by w h i c h c a p i l l a r y 31 h e m o rrh a g e may o c c u r : 1) tio n

H em orrhage p e r

o f blood r e s u l t i n g

T h i s m a y be c a u s e d

rh ex in r e f e r s to

from th e r u p t u r e

by b l u n t ,

tea rin g ,

or

of a

the e x tr a v a s a ­ blood v e s s e l .

co n tu siv e

forces

o f w hich s u c t i o n

o r p o s i t i v e p re s s u re te c h n iq u e s a r e ex am p les. 32 Some i n v e s t i g a t o r s c o n s id e r, fu rth erm o re, t h a t a h y a lu ro n ic acid

c o m p o n e n t o f p e r i v a s c u l a r t i s s u e m a y be l i q u i f i e d

h y a lu ro n id ase under c e rta in tio n

co n d itio n s,

and e v e n t u a l r u p t u r e o f th e s e 2)

d itio n s

"c a p illa rie s"

and la r g e r v e sse ls

had f a lle n

has

receiv e c a re fu l

on t h e

n ic tita tin g 3)

a satio n

been r e i n t r o d u c e d

e x ists

of

ath ero m ato u s w hich 33 by C o p l e y and

c o n s i d e r a t i o n w i t h r e f e r e n c e to work 24 o f t h e r a b b i t * s eye p r e v i o u s l y c i t e d •

sm all

q u a n titie s

u n ru p tu re d w a ll o f blood v e s s e ls u ity

con­

T h is te rm in o lo g y ,

H em orrhage p e r d i a p e d e s in

o f very

b leed in g

lum inal su rfa c e

by e m b o li o r

p e rfo ra tio n .

sho u ld

co n sid ers

o f the

p a tc h e s w hich r e s u l t i n in to d isu se,

the d i l a t a ­

v essels.

H em orrhage p e r d i a b r o s i n

b ro u g h t a b o u t by e ro s io n

p erm ittin g

by

betw een a d j a c e n t

d escrib es

th e e x tr a v ­

of w hole b lo o d th ro u g h th e i n w hich a s l i g h t

e n d o th elial c e lls .

d isco n tin ­

Such sm a ll

hem o rrh ag ic m a n if e s ta tio n s o f p in - p o in t to p in - h e a d s i z e ig n a te d as p e t e c h i a e a r e n o t

co n sid ered

-6 -

to in v o lv e

des­

a m ajor

perforation of the capillary wall but a passage of blood th rough th e

in te rc e llu la r

s p a c e s due t o m a lfo rm a tio n o f th e

in te rc e llu la r

cem ent o r t o a d y s fu n c tio n in

m an u factu re.

S in ce

d ica te s

th a t th e

in te rc e llu la r any i n j u r y

process of 34 t h e woric o f C h a m b e r s a n d Z w e i f a c h in ­

s u p r a e n d o th e lia l l in i n g as w ell as th e

cem ent i s

to th e

c e ll,

a product of th e

e ith er

to the

ecchym oses,

for v ario u s

The d i f f e r e n c e

ex tra v asatio n

and s u g g i l a t i o n s

one

to r h e x is )

and s u g g i l a t i o n

is

(i.e .,

w hile

and ecc h y m o ses i s

th6

th e

form er due t o

d ifferen ce

co n sid ered to

m e n ta ry m echanism s o f c a p i l l a r y u p o n by m an y f a c t o r s

are

des­

ty p es o f p u rp u ric m a n ife s ta tio n s .

b etw een p e t e c h i a e

be a q u a l i t a t i v e la tter

may p e r m i t t h e

s p o n t a n e o u s l y o r upon s t r e s s .

P e tech iae, ig n atio n s

e n d o th e lia l c e lls ,

t h e r e f o r e , w hich w i l l im p a ir i t s

cem ent p ro d u cin g c a p a c i t i e s , o f blood

its

b e liev e d

d iap e d esis,

betw een ecch y m o sis

be q u a n t i t a t i v e .

The e l e ­

b le e d in g , however a re

and g o v e rn e d i n

in te n sity

acted

by c o m p l e x

h e m o s ta tic m echanism s. F a c t o r s R e g u l a t i n g C a p i l l a r y H em orrhage Many f a c t o r s a r e to p lay a ro le (fig .l)

in th e

in clu d e:

1)

b eliev ed

p ro d u ctio n

th e

stren g th

i n t r a v a s c u l a r p r e s s u r e f 3)

the

the q u a lity

cedient, t h e

i

These the

to n u s o f t h e v e s s e l and

4)

the

The f i r s t of th e

p e ric a p illa ry

-

phenomena.

2)

and q u a n t i t y

tu rg o r o f th e

of p u rp u ric

14

o f t h e c a p i l l a r y w all^

m echanism s r e g u l a t i n g h e m o s t a s i s . in clu d es

by c u r r e n t i n v e s t i g a t o r s

9-

of th ese

facto rs

in te r-e n d o th e lia l sh e ath and m a trix ,

and

and

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r e s tin g stag e

P erio d of re s is ta n c e

F ig.

4

o f the h a i r

from 3 0 th to

from 3 5 th t o

37th day.

G raph o f a v e r a g e p e t e c h i a l restin g

ad m in istered

cy cle

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betw een 22nd and 3 0 th day;

of fra g ility

first

o c cu rre n c e p e r an im al in th e

35th day;

p erio d

p erio d o f tu r g id ity

o c c u rre n c e p e r an im al i n th e

stag e under th e in flu e n c e t h y r o x in from t h e 1 8 th t o

p o stn a ta l l i f e .

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5

Graph o f a v e r a g e p e t e c h i a l o c c u r r e n c e p e r a n im a l i n first

restin g

stag e

upon th e

in tr a g lu te a l a d m in istratio n

o f e s t r a d i o l b en zo ate begun a t th e c o n tin u ed up to

the 4 0 th day.

th e

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The e r u p t i o n

o f h a i r on

e x p e rira e n ta ls o c c u rre d on th e f o r t y - s i x t h d a y .

F ig .

6

Graph o f a v e r a g e p e t e c h i a l o c c u r r e n c e p e r a n im a l i n first

restin g

stag e

te n d in g from th e

under th e

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10

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INANI TI ON

F R O M 2 0 ° ' T O 3 9 ,K DAY

54

M

ERUPTION AFTER INANITION

F ig .

7

Graph o f a v e r a g e p e t e c h i a l o c c u r r e n c e p er a n im a l in th e f i r s t r e s t i n g s t a g e a f t e r t h e a d m i n i s t r a t i o n o f 500 R oen tgen U n i t s on th e 2 1 s t day o f a g e .

F ig .

8

G raph o f a v e r a g e p e t e c h i a l o c c u r r e n c e the

first

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750 R o e n tg e n U n i t s

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